Provider Demographics
NPI:1457950214
Name:DUTTON, TYREE LEIGH (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TYREE
Middle Name:LEIGH
Last Name:DUTTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1815
Mailing Address - Street 2:
Mailing Address - City:EAST HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59635-1815
Mailing Address - Country:US
Mailing Address - Phone:406-594-0121
Mailing Address - Fax:
Practice Address - Street 1:639 HELENA AVE STE B
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3607
Practice Address - Country:US
Practice Address - Phone:406-594-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT158225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist